Finally got my path report—need a little help

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surprisedat65
surprisedat65 Member Posts: 73
edited February 2015 in Just Diagnosed

Here's what it says:

Infiltrating High Grade Ductal Carcinoma

Invasive Carcinoma Size - 1.1 cm at least [mammo & ultra sound said 2.5]

In-situ Component - Ductal Carcinoma In-situ (DCIS) Grad 3 w/ Comeo Necrosis

Histologic Type of Invasive Carcinoma - Invasive Ductal Carcinoma

Histologic Grade (SBR Notingham - Grade 3) (Tubules - 3, Nuclear Score - 3, Mitotic Score - 3)

ER Receptor 97% Strong Intensity Positive

PR Receptor 21% Moderate Intensity Positive

HER-2 (1+) Negative

MIB-1 (Ki-67) 69% HIgh


The lines in bold are what I don't fully understand, but they don't sound good. Why is there both an in-situ and an invasive? What are the Histologic Grades and the MIB-1 (Ki-67)

Haven't talked to doctor since the day he told me the biopsy was malignant and further info would come, but forgot to ask for that portion of the path that day. He went out of town for a week and I was not able to get any of the path reports because the doctor had to "sign off" on them when he returned, so that was today and I picked them up.

Having MRI tomorrow and will see surgeon the following Wednesday. This is, well, worse than I feared, but I guess I'm not alone in that.

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited February 2015

    Hi surprised - Sorry about the bad news.

    In-situ Component means they found DCIS along with the IDC which is trumped by the IDC and treatment will mostly likely be geared to the IDC.

    The histological grade is made up of three component for a total possible score of 9. Yours is 9/9 thus grade 3. You can read more about grade on the main pages of BCO. http://www.breastcancer.org/symptoms/diagnosis/cel...

    The Ki-67 test is also a test that some docs order to determine the agressiveness of the cells here is a link to that http://www.breastcancer.org/symptoms/diagnosis/rat...

    Note at the bottom of those a pages is a link to Your Guide to the Breast Cancer Pathology Report is an on-the-go reference booklet you can fill out with your doctor or nurse to keep track of the results of your pathology report. Order a free booklet by mail or download the PDF of the booklet to print it at home.

    Good luck with the MRI. I highly recommend taking the valium they offer because it can be quite claustrophobic. Hang in there. Please let us know how everything is going.

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  • placid44
    placid44 Member Posts: 497
    edited February 2015

    There can be both invasive (ie cells that are capable of invading tissue outside the duct and potentially other parts of the body) and in situ, which stays in the duct and cannot spread. Your invasive portion is small -- that's good. Ki67 is the proliferation rate, or growth rate, for the invasive portion. Yours is high. That's generally not good because it indicates an aggressive tumor, but again, yours is small and less likely to have spread (although that does happen sometimes...it's rare). Also, chemo generally is more effective on high grade/high proliferation tumors because chemo targets fast dividing cells. You are highly ER positive - that's good because it means hormone drugs will be more effective. Your sentinel node biopsy will tell you more about whether there is any cancer in your lymph nodes, which helps determine the stage. My blog below has links to reputable sources regardinghow to read pathology reports.

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  • surprisedat65
    surprisedat65 Member Posts: 73
    edited February 2015

    Thanks, all. I'm just beginning to settle in to the idea that my condition is not going to be as cut and dried as I had imagined. Now all I want to do is get on with it. I am now holding my breath regarding the results of the MRI which I'm having today (Thu). Come to think of it, I guess holding my breath is good practice for that test.

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  • Copperlisa
    Copperlisa Member Posts: 24
    edited February 2015

    Surprisedat65...

    Hoping that the MRI was more comfortable than mine! :) I told the tech that they had obviously invented a new torture device. I am bruised. On a positive note, it brings you one step closer, and answers questions for the surgeon. Prayers for clear answers, and peace for you.



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  • surprisedat65
    surprisedat65 Member Posts: 73
    edited February 2015

    Copperlisa, my MRI was a relative breeze, and whether that's due to my body or the expertise of the practice I'll never know (I hope, meaning I hope I won't need another in the future). I only had to stay in position for 20 minutes, they let me know when halftime was, and I got to listen to music I liked, altho' I should have asked it to be made LOUDER!

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